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©The Author(s) 2025.
World J Transplant. Sep 18, 2025; 15(3): 100111
Published online Sep 18, 2025. doi: 10.5500/wjt.v15.i3.100111
Published online Sep 18, 2025. doi: 10.5500/wjt.v15.i3.100111
Table 1 Baseline demographics and clinical characteristics of study cohort, n (%)
Characteristics | Total (n = 70) | Normal acid exposure (n = 52) | Increased acid exposure (n = 18) | P value |
Follow up, (years), mean ± SD | 2.23 ± 1.87 | 2.24 ± 2.03 | 2.22 ± 1.34 | 0.97 |
Male sex | 41 (58.6) | 30 (57.7) | 11 (61.1) | 1.00 |
BMI, mean ± SD | 26.8 ± 4.56 | 27.4 ± 4.40 | 25.4 ± 4.80 | 0.11 |
Age at transplant, mean ± SD | 56.3 ± 12.5 | 56.7 ± 12.5 | 55.0 ± 13.0 | 0.62 |
White race | 67 (95.7) | 51 (98.1) | 16 (88.9) | 0.16 |
Pulmonary diagnosis | ||||
ILD | 40 (57.1) | 28 (53.8) | 12 (66.7) | 0.41 |
IPF | 22 (31.4) | 14 (26.9) | 8 (44.4) | 0.24 |
COPD | 15 (21.4) | 13 (25.0) | 2 (11.1) | 0.32 |
Other | 17 (24.3) | 13 (25.0) | 4 (22.2) | 1.00 |
Cardiac function, baseline | ||||
LVEF, mean ± SD | 60.9 ± 5.48 | 60.3 ± 5.72 | 62.7 ± 4.40 | 0.11 |
PaP, mean ± SD | 26.6 ± 9.36 | 27.7 ± 10.3 | 23.5 ± 4.62 | 0.03 |
PCWP, (mm Hg), mean ± SD | 10.3 ± 4.90 | 10.8 ± 5.18 | 8.82 ± 3.71 | 0.16 |
PVR (dynes/cm5), mean ± SD | 225 ± 134 | 230 ± 145 | 212 ± 91.9 | 0.64 |
Pulmonary function, baseline | ||||
FVC, mean ± SD | 2.00 ± 0.77 | 1.99 ± 0.67 | 2.03 ± 1.01 | 0.87 |
FVC, %-pred, mean ± SD | 0.49 ± 0.15 | 0.50 ± 0.16 | 0.46 ± 0.12 | 0.29 |
FEV1, mean ± SD | 1.36 ± 0.66 | 1.32 ± 0.59 | 1.47 ± 0.85 | 0.44 |
FEV1, %-pred, mean ± SD | 0.42 ± 0.19 | 0.43 ± 0.20 | 0.40 ± 0.18 | 0.63 |
FEV1/FVC, mean ± SD | 0.69 ± 0.23 | 0.68 ± 0.23 | 0.72 ± 0.22 | 0.62 |
Bilateral lung transplant | 36 (51.4) | 29 (55.8) | 7 (38.9) | 0.28 |
CMV mismatch | 18 (25.7) | 15 (28.8) | 3 (16.7) | 0.37 |
Increased risk donor | 11 (15.7) | 8 (15.4) | 3 (16.7) | 1.00 |
Post-transplant infection | 30 (42.8) | 23 (44.3) | 7 (38.9) | 0.79 |
Post-transplant PPI | 54 (77.1) | 38 (73.1) | 16 (88.9) | 0.21 |
≥ 20% FEV1 decline | 18 (25.7) | 11 (21.1) | 7 (38.9) | 0.21 |
Table 2 Baseline demographics of cohort demonstrated no association with forced expiratory volume in 1 decline on time-to-event analysis
Characteristics | Univariate hazard ratio for pulmonary function decline (95%CI) | P value |
Male sex | 2.14 (0.67-6.87) | 0.20 |
BMI | 0.98 (0.87-1.09) | 0.70 |
Age at transplant | 1.00 (0.95-1.04) | 0.85 |
White race | 0.59 (0.08-4.59) | 0.62 |
Pulmonary diagnosis | ||
ILD | 2.29 (0.71-7.39) | 0.16 |
IPF | 2.73 (0.94-7.89) | 0.06 |
COPD | 0 | - |
Other | 0.91 (0.28-2.94) | 0.87 |
Cardiac function, baseline | ||
LVEF | 0.19 (0-4512) | 0.75 |
PaP (mm Hg) | 1.00 (0.95-1.06) | 0.85 |
PCWP (mm Hg) | 1.00 (0.90-1.11) | 0.98 |
PVR (dynes/cm5) | 1.00 (0.99-1.00) | 0.58 |
Pulmonary function, baseline | ||
FVC | 1.14 (0.62-2.11) | 0.67 |
FVC, %-pred | 0.30 (0.01-9.66) | 0.49 |
FEV1 | 1.67 (0.84-3.32) | 0.14 |
FEV1, %-pred | 3.25 (0.24-43.9) | 0.37 |
FEV1/FVC | 6.21 (0.46-83.7) | 0.17 |
Bilateral lung transplant | 0.74 (0.25-2.16) | 0.59 |
CMV mismatch | 0.77 (0.21-2.76) | 0.69 |
Increased risk donor | 0.62 (0.08-4.84) | 0.65 |
Post-transplant infection | 1.40 (0.49-4.01) | 0.53 |
Post-transplant PPI | 1.57 (0.35-7.04) | 0.55 |
Table 3 Multichannel intraluminal impedance and pH measures and time to forced expiratory volume in 1 decline
Characteristics | Univariate hazard ratio for pulmonary function decline (95%CI) | P value | Multivariate analyses (separate models controlling for age, sex, BMI) | P value |
Elevated AET (> 4.2%) | 3.49 (1.15-10.6) | 0.03 | 3.37 (1.08-10.6) | 0.04 |
Elevated total reflux episodes (> 73) | 1.09 (0.34-3.48) | 0.89 | 1.45 (0.40-5.27) | 0.57 |
Elevated proximal acid episodes (> 28) | 3.34 (1.02-11.0) | 0.04 | 3.29 (0.90-12.1) | 0.07 |
- Citation: Lo WK, Fernandez AM, Feldman N, Sharma N, Goldberg HJ, Chan WW. Increased reflux burden on pre-transplant reflux testing independently predicts significant pulmonary function decline after lung transplantation. World J Transplant 2025; 15(3): 100111
- URL: https://www.wjgnet.com/2220-3230/full/v15/i3/100111.htm
- DOI: https://dx.doi.org/10.5500/wjt.v15.i3.100111